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Background: Resistant fungal keratitis is a major cause of corneal blindness, particularly in resource-limited regions where donor tissue is scarce. Amniotic membrane transplantation (AMT) offers potential benefits through its anti-inflammatory, anti-proteolytic, and epithelialization-promoting effects. This study evaluated the efficacy and safety of AMT for treatment-resistant fungal corneal ulcers. Methods: This prospective, single-arm study enrolled consecutive patients with microbiologically confirmed, treatment-resistant fungal corneal ulcers at Al-Azhar University Hospital, Damietta, between January 2022 and October 2023. All patients underwent standardized single- or double-layer AMT. Baseline and follow-up assessments included best-corrected distance visual acuity (BCDVA, logarithm of the minimum angle of resolution [logMAR]), ulcer size, anterior chamber reaction and depth, and presence of blepharospasm or pain (visual analog scale). Clinical evaluations were performed at baseline, 1 day, and 1, 3, and 6 months postoperatively. Treatment success was defined as complete resolution or significant improvement over 6 months. Results: A total of 24 patients (mean [standard deviation] age, 59 [7.5] years; 3:1 male-to-female ratio) with resistant fungal corneal ulcers were studied. Most were rural residents (n = 17, 70.8%), and nearly half were farmers (n = 11, 45.8%). Common comorbidities included hypertension and diabetes mellitus. The median baseline ulcer area was 3 mm²; most ulcers were central (n = 10, 41.7%) or paracentral (n = 8, 33.3%), and 12.5% (n = 3) had perforations. At 6 months, significant improvements were observed: median BCDVA improved from 3.0 logMAR to 2.0 logMAR (P = 0.001), ulcers completely closed (P = 0.001), and the pain score dropped from 2 to 0 (P = 0.001). Anterior chamber reaction and blepharospasm also improved significantly (both P = 0.001). Overall, 91.7% (n = 22) achieved complete resolution or marked improvement, and two patients required further surgery. The results showed progressive benefits throughout the follow-up period. Conclusions: AMT is a safe and effective adjunctive treatment for resistant fungal keratitis, particularly when corneal donors are scarce. The procedure promotes ulcer healing, relieves pain, and improves visual outcomes. Controlled trials are required to confirm these findings and refine patient selection.

Understanding the site conceptual flow model in fractured-controlled rocks near landfills is crucial for monitoring groundwater pollution and addressing key environmental concerns in diverse locations worldwide. Characterizing fractured basalt with suitable spatial resolution remains an open area of research in such hazardous environments. The objective of this study is to explore the potential of integrating Electrical Resistivity Tomography (ERT) and Seismic Refraction Imaging (SRI) techniques for the construction and improved understanding of a site conceptual flow model in fractured basalt under hazardous conditions. The research was conducted in an area with a history of environmental contamination, where fractured basalt acts as a significant migration pathway for pollutants. SRI identified a shallow water table and revealed highly heterogeneous contacts between the saturated fractured basalt (1200–1850 m/s) and the massive basalts (> 3000 m/s). Additionally, the presence of conductive and interflow zones (5–10 Ω.m) at depths of 5 to 12 m indicated potential vertical hydraulic connections with the lower aquifer, allowing local percolation of leachate around the landfills. These findings demonstrate the advantages of the applied approach in delineating prevailing fracture patterns and clarifying pollution scenarios at composite landfills globally. The insights gained from this research have significant implications for improving the understanding of hydrogeological and transport processes in hazardous environments, enabling sustainable management of groundwater resources and effective monitoring of remediation efforts. The site conceptual flow model plays a critical role in achieving these objectives and addressing the challenges associated with groundwater pollution in such complex settings. Highlights Understanding volcanic rock’s flow model aids groundwater pollution monitoring. Integrating hydrological and geophysical data identifies fractured aquifer pathways. Conductive zones facilitate localized leachate percolation. Findings support sustainable groundwater management and pollution monitoring in fractured aquifers.

Sickle cell disease (SCD) is associated with alterations in immune phenotypes. CD4+CD28null T lymphocytes have pro-inflammatory functions and are linked to vascular diseases. To assess the percentage of CD4+CD28null T lymphocytes, natural killer cells (NK), and IFN-gamma levels, we compared 40 children and adolescents with SCD with 40 healthy controls and evaluated their relation to disease severity and response to therapy. Patients with SCD steady state were studied, focusing on history of frequent vaso-occlusive crisis, hydroxyurea therapy, and IFN-gamma levels. Analysis of CD4+CD28null T lymphocytes and NK cells was done by flow cytometry. Liver and cardiac iron overload were assessed. CD4+CD28null T lymphocytes, NK cells, and IFN-gamma levels were significantly higher in patients than controls. Patients with history of frequent vaso-occlusive crisis and those with vascular complications had higher percentage of CD4+CD28null T lymphocytes and IFN-gamma while levels were significantly lower among hydroxyurea-treated patients. CD4+CD28null T lymphocytes were positively correlated to transfusional iron input while these cells and IFN-gamma were negatively correlated to cardiac T2* and duration of hydroxyurea therapy. NK cells were correlated to HbS and indirect bilirubin. Increased expression of CD4+CD28null T lymphocytes highlights their role in immune dysfunction and pathophysiology of SCD complications.

The aim of this work is to study the different factors that affect the outcome of living donor liver transplantation for patients with hepatocellular carcinoma (HCC). Between April 2003 to November 2014, 62 patients with liver cirrhosis and HCC underwent living donor liver transplantation (LDLT) in the National Liver Institute, Menoufia University, Egypt. The preoperative, operative, and postoperative data were analyzed. After studying the pathology of explanted liver; 44 (71 %) patients were within the Milan criteria, and 18 (29 %) patients were beyond Milan; 13 (21.7 %) of patients beyond the Milan criteria were also beyond the University of California San Francisco criteria (UCSF) criteria. Preoperative ablative therapy for HCC was done in 22 patients (35.5 %), four patients had complete ablation with no residual tumor tissues. Microvascular invasion was present in ten patients (16 %) in histopathological study. Seven (11.3 %) patients had recurrent HCC post transplantation. The 1, 3, 5 years total survival was 88.7, 77.9, 67.2 %, respectively, while the tumor-free survival was 87.3, 82.5, 77.6 %, respectively. Expansion of selection criteria beyond Milan and UCSF had no increased risk effect on recurrence of HCC but had less survival rate than patients within the Milan criteria. Microvascular invasion was an independent risk factor for tumor recurrence.

Background: T cells are the primary effector cells that mediate viral clearance in spontaneous recovery from HCV infection and T cell dysfunction is a hallmark of progression to chronic HCV infection. Material and methods: This study included 49 well charcterised HCV genotype 4-infected patients at Egyptian Liver Research Institute and Hospital (ELRIAH), Mansoura, Egypt, who were enrolled to receive direct acting antiviral therapy for hepatitis C. Immuno-phenotyping was performed to assess the expression of multiple T cell lineage, activation and inhibitory receptors. This was done before treatment, during treatment, at end of treatment and one year after treatment. 50 patients were also enrolled as control. Results: Our data showed, significant increase in the percentages of CD8+ cells as compared to control group. The percentages of PD-1 expression on the CD8+ T-cell population were signifecntly elevated in patients before treatment (p<0.001). Significant increase in Treg (CD4+CD25hFoxP3+) subsets was noticed in comparison with control patients. The expression of the inhibitory and activated markers in CD8+ T-cells was markedly reduced but more obvious in exhausted cytotoxic T cells compared to baseline finding (p<0.001). exhausted (PD1+CD8+) T-cells from HCV+ individuals reduced markedly after 4 weeks of DAA therapy (by 3 folds, p <0.001). Interestingly it started to increase gradually again at the end of treatment and after 1 year but the increase doesn't reach levels noticed in healthy control subjects. Conclusion: Understanding the mechanisms of immune dysfunction and barriers to immune restoration after HCV cure will aid in better understanding of the remaining negative long-term health outcomes for HCV patients and the possibility of HCC development. Competing Interest Statement The authors have declared no competing interest.